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目的观察乌药、大黄合用对重症胰腺炎患者胃肠功能恢复的治疗作用。方法将我科于2009年1月至10月收治的45例重症胰腺炎患者随机分为3组(n=15):常规治疗组,在抑制胰酶分泌和抗感染等传统治疗的基础上给予50%硫酸镁50ml胃管注入,2次/d;大黄组,在传统治疗的基础上给予大黄水煎液100ml高位保留灌肠,2次/d;乌药+大黄组,在传统治疗的基础上给予乌药水煎液50ml胃管注入,大黄水煎液100ml保留灌肠,2次/d。观察3组患者腹胀改善情况(腹围)、腹压(膀胱测压)、APACHE-Ⅱ评分、中性粒细胞、C反应蛋白及第1、3、5、7、9天血清中二胺氧化酶(DAO)的含量。结果 3组治疗后腹围、腹压、APACHE-Ⅱ评分、中性粒细胞等指标均明显下降(P<0.05或P<0.01),以乌药+大黄组递减最明显,而C反应蛋白无明显变化。DAO含量在3组之间差异有统计学意义(P<0.05),并且每组随着时间的延长而递减。结论乌药、大黄合用能促进重症胰腺炎患者胃肠功能恢复。
Objective To observe the therapeutic effects of combination of Radix et Rhizoma Rhei and Rhubarb on the recovery of gastrointestinal function in patients with severe pancreatitis. Methods Forty-five patients with severe acute pancreatitis admitted to our department from January to October in 2009 were randomly divided into three groups (n = 15): conventional treatment group, which was given on the basis of traditional therapy such as inhibition of pancreatic enzyme secretion and anti-infection 50% magnesium sulfate 50ml tube injection, 2 times / d; rhubarb group, on the basis of traditional treatment given rhubarb decoction 100ml high retention enema, 2 times / d; Radix Rehmanniae + rhubarb group, on the basis of the traditional treatment Given Wuyao Decoction 50ml tube injection, rhubarb decoction 100ml retention enema, 2 times / d. The improvement of abdominal distension (abdominal circumference), abdominal pressure (bladder manometry), APACHE-Ⅱ score, neutrophil, C-reactive protein and the serum levels of diamine in the 1st, 3rd, 5th, 7th and 9th days Enzyme (DAO) content. Results The indexes of abdominal circumference, abdominal pressure, APACHE-Ⅱ score and neutrophil in three groups were significantly decreased (P <0.05 or P <0.01) obvious change. There was a significant difference in DAO content between the three groups (P <0.05), and each group decreased with time. Conclusion UF and rhubarb combined can promote gastrointestinal function recovery in patients with severe pancreatitis.